Individual
STACY LYNN PRESCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2635 N 7TH ST, GRAND JUNCTION, CO 81501-8209
(970) 298-2551
Mailing address
2635 N 7TH ST, GRAND JUNCTION, CO 81501-8209
(970) 298-2551
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
44622
CO
207P00000X
Emergency Medicine Physician
G79689
CA
207P00000X
Emergency Medicine Physician
Primary
MD2014-0253
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G796890
BLUE SHIELD
CA
05
—
0G796890
—
CA
Enumeration date
11/04/2005
Last updated
02/16/2024
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